CAJ | 학술논문

目的通过检测COPD患者外周血中Th17细胞、CD4+ Treg细胞占CD4+T细胞的比例及其比值、血浆中的弹性蛋白抗体水平,分析它们在COPD发病中可能的作用.方法采用流式细胞分析技术检测所有受试者外周血Th17细胞及CD4+ Treg细胞占CD4+T细胞的比例,酶联免疫吸附法检测血浆中弹性蛋白抗体水平.结果 ①COPD患者急性加重期组外周血Th17细胞占CD4+T细胞的比例,显著高于缓解期组和健康对照组,缓解期组显著高于健康非吸烟组,差异有统计学意义(P＜0.05),缓解期组高于健康吸烟组,但两者相比较差异无统计学意义.与健康非吸烟组相比,COPD急性加重期组、缓解期组和健康吸烟组外周血CD4+ Treg细胞占CD4+T细胞的比例显著增高,差异有统计学意义(P＜0.05),缓解期略高于急性加重期,高于健康吸烟对照组,但三者比较差异无统计学意义.急性加重期Th17/CD4+ Treg的比值明显增高,与缓解期组、健康吸烟组和健康非吸烟组相比差异有统计学意义(P＜0.05).②各组均检测到弹性蛋白抗体,COPD组、健康吸烟组的弹性蛋白抗体水平较健康非吸烟组增高,差异有统计学意义(P＜0.05),但急性期组、缓解期组、健康吸烟组之间差异无统计学意义.③COPD急性加重期组、缓解期组Th17与弹性蛋白抗体呈正相关(P＜0.05).COPD缓解期组Th17与FEV1％pred和FEV1/FVC呈显著负相关(P＜0.05).结论 Th17细胞、CD4+ Treg细胞及弹性蛋白抗体可能参与了COPD的发生和发展.Th17细胞增高、CD4+ Treg细胞增高相对不足与COPD发病及发展密切相关.Th17在COPD中的表达增高可能加重了肺组织的破坏,这提示它可能在COPD肺气肿弹性蛋白免疫学特异性表达中发挥重要作用.
목적 통과검측COPD환자외주혈중Th17세포、CD4+ Treg세포점CD4+T세포적비례급기비치、혈장중적탄성단백항체수평,분석타문재COPD발병중가능적작용.방법 채용류식세포분석기술검측소유수시자외주혈Th17세포급CD4+ Treg세포점CD4+T세포적비례,매련면역흡부법검측혈장중탄성단백항체수평.결과 ①COPD환자급성가중기조외주혈Th17세포점CD4+T세포적비례,현저고우완해기조화건강대조조,완해기조현저고우건강비흡연조,차이유통계학의의(P＜0.05),완해기조고우건강흡연조,단량자상비교차이무통계학의의.여건강비흡연조상비,COPD급성가중기조、완해기조화건강흡연조외주혈CD4+ Treg세포점CD4+T세포적비례현저증고,차이유통계학의의(P＜0.05),완해기략고우급성가중기,고우건강흡연대조조,단삼자비교차이무통계학의의.급성가중기Th17/CD4+ Treg적비치명현증고,여완해기조、건강흡연조화건강비흡연조상비차이유통계학의의(P＜0.05).②각조균검측도탄성단백항체,COPD조、건강흡연조적탄성단백항체수평교건강비흡연조증고,차이유통계학의의(P＜0.05),단급성기조、완해기조、건강흡연조지간차이무통계학의의.③COPD급성가중기조、완해기조Th17여탄성단백항체정정상관(P＜0.05).COPD완해기조Th17여FEV1％pred화FEV1/FVC정현저부상관(P＜0.05).결론 Th17세포、CD4+ Treg세포급탄성단백항체가능삼여료COPD적발생화발전.Th17세포증고、CD4+ Treg세포증고상대불족여COPD발병급발전밀절상관.Th17재COPD중적표체증고가능가중료폐조직적파배,저제시타가능재COPD폐기종탄성단백면역학특이성표체중발휘중요작용.
Objective To investigate the proportion of blood Th17 and CD4+ regulatory T cells (Treg) and plasma elastin antibodies quantity in patients with chronic obstructive pulmonary disease (COPD),and to analysis their possible role in the development of COPD.Methods Th17 and CD4+ Treg were quantified by flow cytometry in peripheral blood of all subjects,ELISA was used to determine the levels of elastin antibodies in their plasma.Results ①The percentage of Th17 on peripheral blood CD4+ T in COPD acute exacerbation was significantly higher than catabasis and normal control group,and catabasis was significantly higher than normal no-smoking control group (P ＜0.05),no significant difference between COPD catabasis and normal smoking control group.The percentage of CD4+ Treg on peripheral blood CD4 + T in COPD acute exacerbation and catabasis and normal smoking control group was significantly higher than normal no-smoking control group (P ＜0.05),but no significant difference was found compared the three groups.Th17 and CD4+ Treg ratio in COPD acute exacerbation was significantly higher than catabasis and normal control group (P ＜ 0.05).②Elastin antibodies was detected in all subjects,the content of elastin antibodies in plasma of normal no-smoking control group was significantly lower than COPD acute exacerbation and catabasis and normal smoking control group (P ＜0.05),but compared COPD acute exacerbation and catabasis and normal smoking control group,no significant difference was found.③A positive correlation between Th1 7 cells and Elastin antibodies was found in COPD acute exacerbation and catabasis.Th17 and FEV1％ pred and FEV1/FVC presented negative correlation in COPD catabasis.Conclusions Th17 and CD4+ Treg and elastin antibodies maybe be implicated in the pathogenesis of COPD.Th17 cells increase and CD4+ Treg cells raised relative shortage are closely associated with development of COPD.Increase of Th17 expression maybe increase the destruction of lung tissue,suggesting that it maybe play an important role in the COPD pulmonary emphysema elastic protein immunology specific expression.